What is Ethanol Ablation for Thyroid Cancer?

(at the end of this post, check out the downloadable I made for anyone with “good cancer.”)

This week I had two treatments of ethanol ablation for my thyroid cancer. What, you might ask, is ethanol ablation?

Good question. I didn’t know, either, and had a hard time finding information about it other than medical journals and academic papers online. I wanted stories, examples, personal perspectives, and there just aren’t many.

Quick overview: I was diagnosed in September 2018 with thyroid cancer (thyca). In November, I had a total thyroidectomy (TT) but no neck dissection. The tumor was big but didn’t involve any margins so we assumed the doc got it all.

In January 2019, I took the next step of treatment, radioactive iodine (RAI). This involved taking a radioactive pill and going into isolation until my body stopped being nuclear. This also seemed to work.

In July 2019, I had a follow-up ultrasound which revealed a suspicious lymph node. This was biopsied and proved malignant. Cancer was back, or rather, still there and now exposing itself. In January, another lymph node popped up.

Enter, ethanol ablation.

This is a procedure that isn’t done in very many places in the USA, but is done at Mayo Clinic in Rochester, Minnesota. It is only an option if there are three or fewer involved lymph nodes, if they are of a certain size and type of cancer, and if they are in locations amenable to the procedure. If these requirements are not met, surgery is the way to go.

After several consultations with multiple endocrinologists, a surgeon, a radiologist, blood work, ultrasounds, etc, we concluded that my cancer was a good candidate for the ablation treatment.

This certainly sounded better to me than another surgery. Though the first surgery, the one that removed the thyroid, was a much bigger deal since it removed a vital organ, a second one has risks involved, would mean more complicated future surgeries should thyca continue to poke up its head in my neck (which is pretty likely with this kind of cancer that is quite literally, a pain in the neck), and would require a much longer recovery time. It would also leave a scar from my neck to my ear, but I don’t care about scars. I kind of like them, even, in a dark and morbid way.

Ethanol Ablation could be sort of compared to a biopsy, or maybe a biopsy on steroids. Only instead of taking something (tissue) out, the doc puts something in (alcohol, or ethanol).

Under ultrasound guidance and with loads of lidocaine numbing up the area, and numbing it way down deep, the doctor very carefully injects the affected lymph nodes with small amounts of ethanol. The amount varies, depending on the size of the node. It needs to be done very carefully because should the ethanol leak onto nearby structures, they would be damaged.

It is done while the patient (ie, me) is awake and trying desperately to not move and to not think about what is going on in the neck. This is both to avoid general anesthesia and to enable the doctor to check in with the patient. For example, she had me talk to her a couple of times to make sure my vocal chords weren’t being impacted.

Depending on location, size, number, etc, the procedure can take between 30-60 minutes.

Of course the lidocaine helps but of course the lidocaine burns going in and isn’t 100% effective in masking all pain.

How to describe the pain?

For me, filling the first node was fine. Well, not fine, but with deep breathing, I got through it. The second one? DANG. I actually cried, it hurt so bad. And I have given birth to two of my three children without any pain medication (the other one was a c-section, so bring on the drugs).

Burning pressure are two words I could use, though “pressure” doesn’t sound all that bad. It was bad. It was all I could do to not jerk my head away but to stay still and tell myself, this is healing me, this is good for me.

Then it was over. Take an ice pack, load up on Tylenol, go watch a movie or take a nap.

And in the morning, go do it again. Twice, to give the darn cancer a one-two punch. To check on what was going on in the nodes and to fill them up again.

Only this time, the neck is already tender and bruised and my mind knew what was coming. I’m not sure that was helpful or not. It made me nervous but it also helped me brace myself.

After the first treatment, I felt a little nausea though I’m sure that was more nerves and emotions than due to the treatment. After the second one, I suddenly got the shakes. I had to sit down on a ledge at the hospital and cry for a second before being ready to go home. I’m sure that was also emotion and not from the procedure.

In the car, I fell asleep. Then I slept another 9 hours and woke up with a swollen, bruised neck, but no other side effects.

I ran an errand that next day and thought, “Oh, I feel good.” But then the next thought was, “I had cancer treatment yesterday.” And I almost had to sit down. It still just seems bizarre, like another world, that I have cancer. Or maybe I don’t now. Maybe it is gone.

Ethanol ablation requires follow-up in 3-6 months. There is a decent chance that I’ll need to do the whole thing again. And there is always the chance another lymph node will pop up. Thyroid cancer apparently has a habit of not really going away, especially once it has acted like mine.

All in all, not a bad way to treat cancer. Not good either, the only comfortable thing about all of it was the warm blanket they wrapped me up in for the procedure (life hack: when someone asks if you want a heated blanket, the answer is always, “yes”).

I think the emotional and internal work of all this since September 2018 has been harder than the physical. But, for now, I’m putting it behind me and moving forward. There’s nothing else to do besides schedule the next appointments and take my medication every day.

Onward.

New Hymn Ideas Like, “Tender Mother Hen”

A question:

Why don’t we ever sing songs about God, our Tender Mother Hen? (Luke 13:34)

I heard a song a few months ago that was about going out and bringing home the head of my enemy. I know the “enemy” was sin. I get it. But it wasn’t an image that inspired worship. At least, it didn’t inspire worship in that moment. Maybe it is just me, but the image of myself holding a bloody head, separated from its body, while useful in appreciating how serious I should take the fight against sin, wasn’t one I wanted to summon while singing in church.

So I wondered if we could have some songs with different kinds of imagery? This made me consider various passage of scripture that present God in unconventional ways. By unconventional, I mean ways in which God is not commonly thought about in our current culture. I do know that there are some lovely songs out there. Just making suggestions for more.

Maybe a song-writer would like to write a song about God, our tender mother hen.

Or God, Glorious in Breastfeeding? (Isaiah 49:15)

Or God, holy in giving birth? (Deuteronomy 32:18)

God, beautiful in bearing the people? (Isaiah 42:14)

God, strong as a mother bear? (Hosea 13:8)

God, tender as a comforting mother? (Isaiah 66:13)

God, like a poor widow persistent in pursuit? (Luke 15:8-10)

I’m not a singer or a song-writer. I have zero musical talent. But I’m sending a call out to those with talents in this realm. Please write us a song about God, our warrior mother hen, gathering up the chicks and sheltering us, providing for us, loving us.

 

By |February 17th, 2020|Categories: Uncategorized|0 Comments

10 (or 9) Dark Things about Valentine’s Day

In going through some old essays, I found this. I wrote it for Babble and now I know why I didn’t continue writing for Babble longer than just a few years. The site was about cute memes, celebrity news, and feel-good posts. Apparently, I tend toward dark.

These stats are few years old and though I’m not sure I would say things so darkly at this point in life, I’m going to repost this. It is interesting, at least.

I also can’t count because there are really only 9 things on this list.


 

I’m all for showing love and affection. I’m just all for doing it year round and doing it in a way that doesn’t promote weight gain, child slavery, or cheating spouses. Valentine’s Day, as ruthlessly shoved down our throats by advertising and societal expectations, carries some dark stories.

I’m not anti-Valentine’s Day but I want to love my husband and my children while making wise choices, remaining loyal, eating food that actually tastes good, and not harming others in the process. And I want to do it any day of the year without feeling ordered around by a calendar or a custom.

Here are 10 (or 9) dark things about our day of love.

 

Cheating. Ashley Madison, a website that helps people find other with whom to cheat, reports that the day after Valentine’s Day, the day after being let down by their partner, the day after their expectations were raised and then crushed, is their biggest day of the year.

Origins. Some say Valentine’s Day traces its roots to an ancient pagan holiday called Lupercalia, in which men stripped naked, grabbed whips, and spanked young women in hopes of increasing their fertility.

Other Origins. Others say It began as a liturgical celebration of early Christian saints, including honoring the graphic martyrdom of some. It became associated with romance in the high middle ages.

Candy hearts are terrible. They taste like painted cardboard, leave a weird powder on your fingers, and have creepy messages.

Weight gain. Candy, chocolate, dinner out, wine. There are 1400 calories in a one-pound box of chocolates.

Break-ups. Supposedly the percentage of women who would end their relationship if they received nothing for Valentine’s Day is 53%. I must fall in the other 47%.

Money. Last year Americans spent $18.6 billion dollars for Valentine’s Day. $1.9 billion on flowers and $1.6 billion on candy. Maybe that isn’t a bad thing in your opinion, but compared to the Gross National Product of Djibouti (2011), that is a lot of money. The GNP? $1.24 billion

Waste. In the two week period leading up to Valentine’s Day, American sales of gold jewelry lead to 34 million metric tons of waste.

Chocolate and child labor. In West Africa, cocoa is a commodity crop grown primarily for export. As the chocolate industry has grown over the years, so has the demand for cheap cocoa. Today, cocoa farmers barely make a living selling the beans and often resort to the use of child labor in order to keep their prices competitive…

Flowers. In a push to meet the demands of Valentine’s Day, workers have been reported to log up to 20 hours a day, at 250-300 stems per hour. According to the Victoria International Development Education Association, two-thirds of Colombian and Ecuadorian flower workers suffer from work-related health problems, including headaches, nausea, impaired vision, conjunctivitis, rashes, asthma, stillbirths, miscarriages, congenital malformations, and respiratory and neurological problems.

Happy LOVE day!

 


 

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By |February 14th, 2020|Categories: Uncategorized|Tags: |0 Comments

No Longer Covered in Shame

Quick link: Today I have an essay Unclean but Called Clean, at (in)courage.

When I was radioactive and in isolation, I spent a lot of time meditating on shame, fear, healing, and the power of touch, the power of hope, the power of being restored. Here’s what I concluded.


It is a strange and unsettling thing being a danger to society.

I went for a walk and swooped to avoid a woman walking her dog. I crossed the street when a man came toward me, pushing his toddler on a tricycle. The little girl waved and said, “Hi!” and I stepped even further away. I walked down the center of streets, to keep my body as far from animals as possible.

I felt like I should have shouted, “Unclean! Unclean!”

I had every right to go outside. I’d specifically asked my doctor if it’d be okay and she said yes, then backed away from me in the hospital room to demonstrate how far I would have to be from people and pets — a good eight feet.

Still.

What if I slipped and hit my head and people came to help? What if a dog chased me? What if a school bus dropped off a student, and I didn’t get away quickly enough? What if I saw someone I knew and had to ignore or rebuff them?

At home, I lurked in the basement. My mom delivered food but couldn’t stop and chat. I didn’t want her to stay long in the basement air or near my physical space.

I was unclean…


Read the rest of the essay at (in)courage

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